BACKGROUND: Social inactivity after a stroke leads to adverse outcomes, making social activity after discharge important for chronic stroke survivors. This study aimed to investigate the effects of early rehabilitation services after discharge on social activity among chronic stroke survivors.
METHODS: The participants were prospectively recruited from 3 convalescent hospitals. Receipt of early rehabilitation services after discharge for chronic stroke survivors was defined as the utilization of day care or home-based rehabilitation services by the Japanese long-term care insurance system. Social activity was assessed using the Frenchay Activities Index (FAI) premorbid and at 3, 6, and 12 months after discharge. In this study, the outcome was defined as the change in the FAI score from 3 to 12 months after discharge. Multivariate regression analysis was performed to examine the effect of access to rehabilitation on changes in FAI.
RESULTS: Ninety stroke survivors (age 67.2±11.6 years, 52 male) were enrolled. The FAI showed improvements by 27.4% and 1.4% from 3 to 12 months after discharge in the rehabilitation and nonrehabilitation groups, respectively. Multivariate regression analysis showed that access to rehabilitation after discharge was positively associated with the FAI change from 3 to 12 months after discharge (B=30.3, β=0.38, 95% confidence interval=11.13-49.47, P=0.002).
CONCLUSIONS: Early rehabilitation services after discharge were significantly associated with increased social activity.

UNASSIGNED: The purpose of this pilot study was to determine the effectiveness and costs of the occupation-based practice for community dwelling frail elderly.
UNASSIGNED: Pilot pre-post design without a control group.
UNASSIGNED: A care management center involving 37 local elderly.
UNASSIGNED: The final analysis included 26 frail elderly in a community dwelling center.
UNASSIGNED: The intervention was occupation-based practice involving setting of client-centered goals, observation of real living situations, and provision of advice on the individual problem of real occupation.
UNASSIGNED: The outcome was the Frenchay Activities Index (FAI), which is used to evaluate the instrumental activities of daily living (IADL). Additionally, the frequency, duration, and cost of the intervention were calculated.
UNASSIGNED: Regarding the FAI score before and after the interventions, there were significant improvements in all items except work (P<0.05, effect size [r]: 0.67-0.93). A total of 15 people out of 26 (57.7%) showed improvement in activities of daily living. The frequency of interventions was 3.7 (95% confidence interval [CI]: 2.83-4.48), and the duration was 7.4 weeks (95% CI: 5.27-9.42). The average intervention cost was $258 (95% CI: 200.4-317.4).
UNASSIGNED: The results of this study showed that occupation-based practice has a potential to improve IADL in frail elderly, with low frequency of intervention, within a short-term, and direct cost reduction. We believe that this pilot study will contribute to future clinical studies for frail elderly, and the findings can be easily applied to daily clinical intervention. A well-designed prospective randomized-controlled trial is necessary to verify these results.

To describe activity in different aspects of daily life among long-term stroke survivors, and conceptualise the content of the Barthel Index (BI) and the Swedish extended and modified Frenchay Activities Index (mFAI) using the ICF framework.
Assessments were performed by means of the BI and the mFAI at a 10-year follow-up of 145 consecutive stroke survivors from Lund Stroke Register, Sweden. After linking the two instruments to the ICF core set for stroke, data were analysed and presented in terms of activity-specific domain-scores for the total sample and sub-groups according to gender and age.
Together the two instruments covered 69% of the Activities and participation component of the ICF core set for stroke. Two activity-specific domains were identified within the BI and six within the mFAI. Most participants reported a high overall activity level. Inactivity was most common among those ≥80 years. Men and women participated in different types of activities and used different modes of transport.
Long-term stroke survivors have a high activity level in daily life, though individual variation is considerable. The structure provided by linking instruments to the ICF core set for stroke can be used for more fine-tuned descriptions of activity. Implications for Rehabilitation Since most long-term stroke survivors are independent in ADL but may have limitations in other activity domains such as social and leisure activities, these aspects should be considered in the rehabilitation process. Older stroke survivors deserve special attention due to their higher risk of long-term inactivity. The Barthel Index and the Swedish extended and modified Frenchay Activities Index are complementary for assessments of ADL and social activity after stroke and cover over two thirds of the Activities and participation component in the ICF core set for stroke.